System and method for detecting deviations during the course of an orthodontic treatment to gradually reposition teeth

ABSTRACT

Method and system for detecting and correcting deviation during an orthodontic treatment plan is provided. The method includes the steps of receiving an un-segmented current teeth image representing a patient&#39;s teeth after an orthodontic treatment plan has begun and before the plan ends for the patient; matching a previously segmented teeth model with the current teeth image; and generating at least one corrective stage to define an intermediate tooth arrangement, wherein the at least one corrective stage repositions a digital teeth image so that a prescribed tooth arrangement of the previously segmented teeth model can be used.

CROSS-REFERENCE

This application is a continuation of U.S. patent application Ser. No.16/852,251, filed Apr. 17, 2020, now U.S. Patent Application PublicationNo. 2020/0237477, which is a continuation of U.S. patent applicationSer. No. 14/952,642, filed Nov. 25, 2015, now U.S. Pat. No. 10,624,716,which is a divisional of U.S. patent application Ser. No. 14/152,776,filed Jan. 10, 2014, now U.S. Pat. No. 9,364,297, which is acontinuation of U.S. patent application Ser. No. 13/293,916, filed Nov.10, 2011, now U.S. Pat. No. 8,636,510, which is a continuation of U.S.patent application Ser. No. 11/760,612, filed Jun. 8, 2007, now U.S.Pat. No. 8,075,306, the contents of which are hereby incorporated byreference in their entirety.

FIELD OF THE INVENTION

This invention relates to the field of orthodontics, and moreparticularly to a system and method for detecting deviations from aplanned course of treatment to gradually reposition teeth.

BACKGROUND OF THE INVENTION

A fundamental objective in orthodontics is to realign or reposition apatient's teeth to positions where the teeth function optimally andaesthetically. Methods have been developed to reposition a patient'steeth to a prescribed tooth arrangement (i.e. a desired finalarrangement of each tooth in a patient's jaw) according to a plannedcourse of treatment using a series of appliances. The series ofincremental position adjustment appliances are placed over the patient'steeth and gradually reposition the teeth. Each appliance represents apre-existing stage in a series of pre-existing stages for repositioningteeth to a prescribed final position. This is described in U.S. Pat. No.5,975,893; which is assigned to the assignee of the present application,and the complete disclosures of which is incorporated herein byreference.

Ideally, a patient wears each appliance for about two weeks or until thepressure of each appliance on the teeth can no longer be felt. At thatpoint, the patient replaces a current adjustment appliance with a nextadjustment appliance in the series until no more appliances remain.During treatment, a patient may forget to wear the appliances regularlyallowing the patient to stray from the prescribed course. As a result,one or more appliances may not properly fit and the dentist (or anyother medical professional) may have to start the process again(“re-start”) by taking another impression of the patient's teeth so thata new series of incremental position adjustment appliances can beelectronically generated and ultimately manufactured to a new prescribedtooth arrangement.

When a re-start occurs, there is an opportunity to track what progresshas occurred to straighten the patient's teeth. To accurately track theprogress of a patient's teeth, it is desirable to have an exact model ofthe patient's teeth for comparison.

Conventional methods provide process steps for creating generalizedrecord keeping for images of a patient's teeth by moving standard teethin a standard three-dimensional (3D) digital model template to reflectthe general position of a patient's teeth. Since the size and shape ofany tooth of the standard 3D model may vary from actual teeth of thepatient, the images may only provide a visual likeness and not an exacttooth structure or position to allow for accurate tracking of toothmovement or fabrication of adjustment appliances, such as aligners,which use actual teeth geometry.

In conventional methods, a patient's X-ray image is displayed on acomputer screen as a background image for the standard 3D model. Thestandard 3D model is then rotated, translated and scaled by a technicianto match the orientation of the X-ray image. Then the individual teethare adjusted to match those in the X-ray. However, the model generatedby conventional methods is not an exact model of the patient's teeth butmerely an approximate model of the patient's teeth because instead ofactual patient teeth, standard teeth are used. Hence, the patient'sprogress cannot be accurately tracked and reliable data is unavailableto manufacture adjustment appliances.

Therefore, a system and method for detecting deviations from aprescribed course of treatment to gradually reposition teeth to apre-existing prescribed tooth arrangement; and accurately tracking theprogress of a patient's teeth are needed.

SUMMARY OF THE INVENTION

In one embodiment, a method for detecting and correcting deviationduring an orthodontic treatment plan is provided. The method includesthe steps of receiving an un-segmented current teeth image representinga patient's teeth after an orthodontic treatment plan has begun andbefore the plan ends for the patient; matching a previously segmentedteeth model with the current teeth image; and generating at least onecorrective stage to define an intermediate tooth arrangement, whereinthe at least one corrective stage repositions a digital teeth image sothat a prescribed tooth arrangement of the previously segmented teethmodel can be used.

This brief summary has been provided so that the nature of thedisclosure may be understood quickly. A more complete understanding ofthe disclosure can be obtained by reference to the following detaileddescription of the various embodiments thereof in connection with theattached drawings.

INCORPORATION BY REFERENCE

All publications, patents, and patent applications mentioned in thisspecification are herein incorporated by reference to the same extent asif each individual publication, patent, or patent application wasspecifically and individually indicated to be incorporated by reference.

BRIEF DESCRIPTION OF THE DRAWINGS

The novel features of the invention are set forth with particularity inthe appended claims. A better understanding of the features andadvantages of the present invention will be obtained by reference to thefollowing detailed description that sets forth illustrative embodiments,in which the principles of the invention are utilized, and theaccompanying drawings of which:

The foregoing features and other features of the present disclosure willnow described with reference to the drawings of the various embodiments.In the drawings, the same components have the same reference numerals.The illustrated embodiments are intended to illustrate, but not to limitthe disclosure. The drawings include the following Figures:

FIG. 1 shows a block diagram of a computing system for executing processsteps, according to one embodiment of the present disclosure;

FIG. 2 shows the internal architecture of the computing system of FIG. 1:

FIG. 3 is an elevational diagram showing the anatomical relationship ofthe jaws of a patient;

FIG. 4A illustrates in more detail the patient's lower jaw and providesa general indication of how teeth may be moved by the methods and systemof the present disclosure;

FIG. 4B illustrates a single tooth from FIG. 4A and defines how toothmovement distances are determined;

FIG. 5 illustrates the jaw of FIG. 4A together with an incrementalposition adjustment appliance;

FIG. 6 shows a block diagram of a system for correcting deviationsduring the prescribed course of an orthodontic treatment to graduallyreposition teeth, according to one embodiment of the present disclosure;

FIG. 7 is a flow chart showing the steps of correcting deviations duringa prescribed course of treatment to gradually reposition teeth,according to one embodiment of the present disclosure;

FIG. 8 is a screen shot showing a graphical representation of athree-dimensional model of a patient's upper and lower jaws based on acurrent digital data set, according to one embodiment of the presentdisclosure;

FIG. 9 is a graphical representation of a three-dimensional model of aninitial match that can occur when the three dimensional model of digitaltranslated images are overlaid on three dimensional model of the CurrentTeeth Image. according to one embodiment of the present disclosure;

FIG. 10 is a screen shot of a menu for entering bite match settings,according to one embodiment of the present disclosure;

FIG. 11 is a screen shot of a dialog box for displaying the teeth with amatching error greater than pre-determined parameters, according to oneembodiment of the present disclosure;

FIG. 12 is a graphical representation of a three-dimensional model of apatient's upper and lower jaw with a matching error, according to oneembodiment of the present disclosure;

FIG. 13 is an enlarged view of a portion of the jaw in FIG. 12 showingthe matching error to be corrected;

FIG. 14 is an enlarged top view of a portion of the jaw in FIG. 12showing the matching error to be corrected; and

FIG. 15 is a screen shot of a message warning the technician that atleast one tooth is over the acceptable matching surface limit, accordingto one embodiment of the present disclosure.

DETAILED DESCRIPTION OF THE INVENTION

The following definitions are provided as they are typically (but notexclusively) used in the computing and orthodontics environment,implementing the various embodiments disclosed herein.

“Corrected Stages” means creating new stages from a Previously SegmentedTeeth Model(s) stage by causing the teeth in the Previously SegmentedTeeth Model to move from a Current Teeth Image to the same position in apre-existing Prescribed Tooth Arrangement or one of the pre-existingstages of a Previously Segmented Teeth Model so that the PrescribedTooth Arrangement established by the Previously Segmented Teeth Modelcan be used and will not change. Before any new Corrected Stages can bedigitally created, a stage of the Previously Segmented Teeth Model forthe patient captured by the Current Teeth Image is selected and thenadjusted to match the Current Teeth Image. In one embodiment, apre-existing stage corresponds to a previous appliance worn by thepatient or an appliance that was intended to be worn at some time afterthe previous appliance was worn, but before the Prescribed ToothArrangement. By correcting the patient's teeth to the pre-existingPrescribed Tooth Arrangement, a set of new appliance are provided to thepatient, although a last appliance will provide the same PrescribedTooth Arrangement as initially provided. By correcting the patient'steeth to a pre-existing stage, the Prescribed Tooth Arrangement will notchange and any pre-existing appliances may be used, which saves time andmoney to digitally create and physically manufacture new appliances or anew prescribed tooth arrangement.

“Current Teeth Image” means a digital image (two dimensional or threedimensional) representing a patient's teeth at any time after beginningtreatment but prior to the teeth being in a Prescribed ToothArrangement. The image can be taken from a dental impression, a 2D image(such as a camera picture) and a bite registry, multiple 2D images,intra-oral scan of low or high resolution, X-ray, cone scan, CT-scan,and other methods. The Current Teeth Image may be a digital model butmay not be segmented, which is a labor intensive process step. TheCurrent Teeth Image should provide or enable, by software, a certainlevel of clarity of the teeth so that a Previously Segmented Teeth Modelcan be adjusted to match the Current Teeth Image.

“Digital Data Set” means any information that may be used to represent apatient's teeth arrangement. This information may be acquired in aplurality of ways, for example (a) by scanning dental impressions whichare typically received from a dental laboratory; (b) a patient's teethmay be scanned or imaged using X-Rays, cone scan, computer aidedtomographic images; (c) scanning digital pictures of a patient's teeth;(d) scanning and digitizing analog pictures; (e) or any other method.

“Initial Segmented Teeth Model” means the Initial Segmented Teeth Modelthat is created at the beginning of a patient's treatment plan.

“Prescribed Tooth Arrangement” means an arrangement of a patients teethat the end of a treatment plan, created from an Initial Segmented TeethModel.

“Previously Segmented Teeth Model” means a digital 3D segmented modelthat provides specific incremental stages of segmented teeth arrangementto move teeth from the Initial Segmented Teeth Model to the PrescribedTooth Arrangement. The Previously Segmented Teeth Model is createdbefore the Current Teeth Image is available. By comparing a PreviouslySegmented Teeth Model to the initial Corrected Stage, a patient'sprogress during an orthodontic treatment plan can be tracked and anydeviation from the desired treatment path can be detected by atechnician well before a doctor or a patient could recognize thedeviation or understand that it could hinder or prevent the mosteffective and efficient Prescribed Tooth Arrangement.

“Segmented Teeth Model” means a digital 3D model that has been segmentedso that each tooth may be represented as a separate digital object. Thesegmentation step is performed by software and is labor intensive.

“Teeth Model” means a digital 3D model incorporating dental informationassociated with a patient's teeth. Typically, the model is based on theDigital Data Set.

In one embodiment, the present disclosure provides a system and methodfor detecting deviations from a prescribed course of treatment togradually reposition teeth. When a patient's orthodontic treatmentbegins a Segmented Teeth Model is generated and used to create a set ofstages (e.g., pre-existing stages) from the Initial Segmented TeethModel to the Prescribed Tooth Arrangement. From the set of pre-existingstages, a set of incremental adjustment appliances are created to movethe patient's teeth into a prescribed tooth arrangement. However, apatient's teeth may stray from the planned course of treatment. This canbe as a result of unforeseen physical traits of a patient's teeth orprolonged periods of non-use of the appliances by the patient, or someother reason. As a result, one or more appliances will have a geometrythat is inoperative or uncomfortable to wear by the patient. To correctthese deviations, which may occur at any stage of treatment a CorrectedStage or stages are created which will position the patient's teeth toconform to a pre-existing stage or the pre-existing Prescribed ToothArrangement. New appliances are generated from the corrected stage orstages. If the generated appliances manufactured from the CorrectedStages do not bring the patient's teeth directly to the pre-existingPrescribed Tooth Arrangement, they will bring the patient's teeth backin the position of a pre-existing stage so that the already createdappliances can continue to be used to move the patient's teeth into thePrescribed Tooth Arrangement.

There are a number of reasons why the Corrected Stages may move theteeth directly to the pre-existing Prescribed Tooth Arrangement, therebyavoiding the use of pre-existing appliances made from the PreviouslySegmented Teeth Model. For example, the Current Teeth Image may presentsome new treatment difficulties that cannot be effectively andefficiently resolved by the remaining pre-existing appliances, so a newset of appliance will need to be created from the Corrected Stages toreach the Prescribed Tooth Arrangement. On the other hand, logistically,from a distribution aspect, it may be easier and less confusing to sendthe doctor a new complete set of appliances from the Corrected Stagesthan to ask the doctor or patient to integrate a few new appliances fromthe Corrected Stages into the pre-existing appliances from thePreviously Segmented Teeth Model.

The system can be implemented in software and executed by a computingsystem. To facilitate an understanding of the preferred embodiment. thegeneral architecture and operation of a computing system will bedescribed first. The specific process under the preferred embodimentwill then be described with reference to the general architecture.

FIG. 1 is a block diagram of a computing system for executing computerexecutable process steps according to one embodiment of the presentdisclosure. FIG. 1 includes a host computer 2 and a monitor 4. Monitor 4may be a CRT, a LCD, a plasma, or any other type of color or monochromedisplay. Also provided with computer 2 are a keyboard 6 for enteringdata and user commands, and a pointing device (for example, a mouse) 8for processing objects displayed on monitor 4.

Computer 2 includes a computer-readable memory storage device 10 forstoring readable data. Besides other programs, storage device 10 canstore application programs including web browsers and computerexecutable code, according to the present disclosure. According to oneembodiment of the present disclosure, computer 2 can also accesscomputer-readable removable storage devices storing data files,application program files, and computer executable process stepsembodying the present disclosure or the like via a removable memorydevice 12 (for example, a CD-ROM, CD-R/W, flash memory device, zipdrives, floppy drives and others).

It is noteworthy that the present disclosure is not limited to the FIG.1 architecture. For example, notebook or laptop computers, or any othersystem capable of connecting to a network and runningcomputer-executable process steps, as described below, may be used toimplement the various aspects of the present disclosure.

FIG. 2 shows a top-level block diagram showing the internal functionalarchitecture of computing system 2 that may be used to execute thecomputer-executable process steps, according to one embodiment of thepresent disclosure. As shown in FIG. 2 , computing system 2 includes acentral processing unit (CPU) 16 for executing computer-executableprocess steps and interfaces with a computer bus 18.

Also shown in FIG. 2 are an input/output interface 20 that operativelyconnects output display devices such as monitors 4, input devices suchas keyboards 6 and a pointing device such as a mouse 8.

A storage device 22 (similar to device 10) also interfaces withcomputing system 2 via computer bus 18. Storage device 22 may be disks,tapes, drums, integrated circuits, or the like, operative to hold databy any means, including magnetically, electrically, optically, and thelike. Storage device 22 stores operating system program files,application program files, computer-executable process steps of thepresent disclosure, web-browsers and other files. Some of these filesare stored on storage device 22 using an installation program. Forexample, CPU 16 executes computer-executable process steps of aninstallation program so that CPU 16 can properly execute the applicationprogram.

Random access memory (“RAM”) 24 also interfaces with computer bus 18 toprovide CPU 16 with access to memory storage. When executing storedcomputer-executable process steps from storage device 22, CPU 16 storesand executes the process steps out of RAM 24.

Read only memory (“ROM”) 26 is provided to store invariant instructionsequences such as start-up instruction sequences or basic input/outputoperating system (BIOS) sequences.

Computing system 2 can be connected to other computing systems through anetwork interface 28 using computer bus 18 and a network connection (forexample 14). Network interface 28 may be adapted to one or more of awide variety of networks, including local area networks, storage areanetworks, wide area networks, the Internet, and the like.

In one embodiment of the disclosure, course correction software may besupplied on a CD-ROM or a floppy disk or alternatively could be readfrom the network via network interface 28. In yet another embodiment ofthe disclosure, computing system 2 can load the course correctionsoftware from other computer readable media such as magnetic tape, aROM, integrated circuit, or a magneto-optical disk.

Alternatively, the course correction software is installed onto thestorage device 22 of computing system 2 using an installation programand is executed using the CPU 16.

In yet another aspect, the course correction software may be implementedby using an Application Specific Integrated Circuit that interfaces withcomputing system 2.

Turning to FIG. 3 , a skull 30 with an upper jaw bone 32 and a lower jawbone 34 is shown. Lower jaw bone 34 hinges at a joint 36 to skull 30.Joint 36 is called a temporal mandibular joint (TMJ). Upper jaw bone 32is associated with an upper jaw 38, while lower jaw bone 34 isassociated with a lower jaw 40.

A computer model of jaws 38 and 40 is generated, and a computersimulation models interactions among the teeth on jaws 38 and 40. Thecomputer simulation allows the system to focus on motions involvingcontacts between teeth mounted on the jaws and to render realistic jawmovements that are physically correct when jaws 38 and 40 contact eachother. The model of the jaw places the individual teeth in a treatedposition. Further, the model can be used to simulate jaw movementsincluding protrusive motions, lateral motions, and “tooth guided”motions where the path of lower jaw 40 is guided by teeth contactsrather than by anatomical limits of jaws 38 and 40. Motions are appliedto one jaw, but may also be applied to both jaws. Based on the occlusiondetermination, the prescribed tooth arrangement can be ascertained.

Referring now to FIG. 4A, lower jaw 40 includes a plurality of teeth 42,for example. At least some of these teeth may be moved from a PreviouslySegmented Teeth Models to a prescribed tooth arrangement. As a frame ofreference describing how a tooth may be moved, an arbitrary centerline(CL) may be drawn through tooth 42. With reference to this centerline(CL), each tooth may be moved in orthogonal directions represented byaxes 44, 46, and 48 (where 44 is the centerline). The centerline may berotated about axis 48 (root angulation) and axis 44 (torque) asindicated by arrows 50 and 52, respectively. Additionally, tooth 42 maybe rotated about the centerline, as represented by arrow 52. Thus, allpossible free-form motions of the tooth can be performed.

FIG. 4B shows how the magnitude of any tooth movement may be defined interms of a maximum linear translation of any point P on tooth 42. Eachpoint P will undergo a cumulative translation as tooth 42 is moved inany of the orthogonal or rotational directions defined in FIG. 4A. Thatis, while point P will usually follow a nonlinear path, there is alinear distance between any point P in the tooth when determined at anytwo times during the treatment. Thus, an arbitrary point P1 may in factundergo a true side-to-side translation as indicated by arrow d1. whilea second arbitration point P2 may travel along an arcuate path,resulting in a final translation d2. Many aspects of the presentdisclosure are defined in terms of the maximum permissible movement ofpoint P1 induced on any particular tooth. Such maximum tooth movement,in turn, is defined as the maximum linear translation of point P1 on thetooth that undergoes the maximum movement for tooth 42 in any treatmentstep.

FIG. 5 shows one adjustment appliance 54 which is worn by the patient inorder to achieve an incremental repositioning of individual teeth in thejaw as described generally above. Appliance 54 is a polymeric shellhaving a teeth-receiving cavity. This is described in U.S. Pat. No.6,450,807, which claims priority from U.S. Pat. No. 5,975,893, which inturn claims priority from provisional application Ser. No. 06/050,352,filed Jun. 20, 1997 (collectively the “prior applications”); all ofwhich are assigned to the assignee of the present application, and thedisclosures of which are incorporated herein by reference in theirentireties.

As set forth in the prior applications, each polymeric shell may beconfigured so that its tooth-receiving cavity has a geometrycorresponding to a pre-existing stage intended for appliance 54. Thepatient's teeth are repositioned to a prescribed tooth arrangement byplacing a series of incremental position adjustment appliances over thepatient's teeth. The adjustment appliances are generated at thebeginning of the treatment from pre-existing stages generated from animpression taken of the patient's teeth. Ideally, the patient wears eachappliance for two weeks or until the pressure of each appliance on theteeth is minimal. At that point, the patient moves onto the next stageof the planned course of treatment and replaces the current adjustmentappliance with the next adjustment appliance in the series until no moreappliances remain. Conveniently, the appliances are generally notaffixed to the teeth and the patient may place and replace theappliances at any time during the procedure.

The polymeric shell 54 can fit over all teeth present in the upper orlower jaw. Typically, only certain one(s) of the teeth will berepositioned while others of the teeth will provide a base or an anchorregion for holding appliance 54 in place as appliance 54 applies aresilient repositioning force against the tooth or teeth to berepositioned. In complex cases, however, multiple teeth may berepositioned at some point during the treatment. In such cases, themoved teeth can also serve as a base or anchor region for holding therepositioning appliance.

Polymeric appliance 54 of FIG. 5 may be formed from a thin sheet of asuitable elastomeric polymer, such as Tru-Tain 0.03, in thermal formingdental material, available from Tru-Tain Plastics, Rochester, Minn.Typically, no wires or other means will be provided for holding theappliance in place over the teeth. In some cases, however, it will bedesirable or necessary to provide individual anchors on teeth withcorresponding receptacles or apertures in appliance 54 so that theappliance can apply an upward force on the tooth that would not bepossible in the absence of such an anchor.

As discussed above, a patient's teeth may stray from the planned courseof treatment. This can be as a result of unforeseen physical traits of apatient's teeth, prolonged periods of non-use of the appliances by thepatient or other reasons. As a result, one or more appliances will havea geometry that is undesirable or unable to effectively move teeth to adesired position or stage. Without the system and method of the presentdisclosure, the dentist would have to start the repositioning processagain by taking another impression of the patient's teeth.

The new impression for the re-start process captures the patient's newinitial or current position so that a new 3D digital model of the teethcan be created, each tooth defined and segmented, the gingival lineformed, and all stages created to effectively move the teeth from acurrent position to a new prescribed tooth arrangement. The prescribedtooth arrangement is new during a re-start case because the new stagescreated during this process are never matched to a pre-existing stage orthe pre-existing prescribed tooth arrangement, but instead create newstages to reach a new, yet similar, prescribed tooth arrangement. Thisis described in U.S. Pat. No. 7,077,647, which is assigned to theassignee of the present application, and the complete disclosure ofwhich is incorporated herein by reference.

In contrast, the system and method of the present disclosure allows foradjustment of any teeth that are off track from any of the pre-existingstages to a Corrected Stage(s) to reach the pre-existing PrescribedTooth Arrangement or a pre-existing stage of the Previously SegmentedTeeth Model. The corrected stage or stages are used to create theadditional appliances.

FIG. 6 shows a block diagram of a system 56 for correcting deviationsfrom a planned orthodontic treatment course to gradually repositionteeth, according to one embodiment of the present disclosure. System 56comprises an analysis module 58 having a receive module 60 for receivinginput data 62. Input data 62 includes (1) Current Teeth Image; and (2)Previously Segmented Teeth Model.

A technician obtains a Previously Segmented Teeth Model or an InitialSegmented Teeth Model that was created from the initial impression ofthe patient's teeth taken at the beginning of the orthodontic treatment.The technician can use any stage of the Previously Segmented TeethModel. For tracking purposes and analysis to correct similar deviationsin the future, the technician will typically use the stage of thePreviously Segmented Teeth Model that is most closely related to theCurrent Teeth Image. In other words, the stage Previously SegmentedTeeth Model for the last appliance worn or next to be worn is likely tobe used.

The Current Teeth Image may be generated from an impression of thepatient's teeth, a 2D image (such as a camera picture) and a biteregistry. multiple 2D images, intraoral scan of low or high resolution,X-ray, CT-scan and others taken during the course of the treatment. Atechnician pre-processes the Current Teeth Image, prior to being inputinto receive module 6 by manually assigning a unique Facial Axis of theClinical Crown (FACC), a unique current identifier (e.g., abnormalitiesin a tooth or attachments or markers placed on a tooth), or by using acusp or surface matching algorithm, to each tooth. Each tooth in thePreviously Segmented Teeth Model is already assigned a unique startingidentifier like FACC.

A compare module 66, within analysis module 58, compares the Currentteeth Image with the Previously Segmented Teeth Model to determine ifthere is an initial match. To determine if there is an initial match,the Current teeth Image with the Previously Segmented Teeth Model areoverlaid on each other and the relative location of each tooth isidentified by its unique identifier or FACC. If no mismatches aregenerated, an initial match occurs. The initial match confirms that thetechnician is using the correct Previously Segmented Teeth Model for theCurrent Teeth Image.

A mismatch occurs if there are any teeth numbering irregularities, forexample, the total number of teeth in each model is not the same, or atleast one tooth is missing a FACC.

A technician reviews mismatch details and corrects the mismatch (es) bymanually adjusting or repositioning each tooth with a mismatch using thePreviously Segmented Teeth Model or adjusting information relating toeach tooth with a mismatch, as described below. By knowing a currentlocation of each tooth, the difference between the current location anda previous location can be measured and tracked to understand theadjustments made and possibly how to prevent a similar deviation in thefuture. In addition, based on this distance, the technician uses thePreviously Segmented Teeth Model to move or reposition each tooth with amismatch from its present location to a desired location.

When the technician adjusts the Previously Segmented Teeth Model, theadjustment data is input into receive module 60 and sent torepositioning module 67 which receives the data via compare module 66.Repositioning module 67 uses this data to reposition the teeth withmismatches. When the mismatches have been corrected, the correctedstages are transmitted back to compare module 66 and the process isrepeated until an initial match is achieved. The initial match providesa good starting position for the next step in the process, matching thesurfaces of the corresponding teeth.

After an initial match is achieved, compare module 66 executes a surfacematching algorithm which prompts the technician to enter bite matchsettings. Bite match settings include pre-determined tolerances and thenumber of times a surface matching algorithm can be executed, asdescribed below with reference to FIG. 10 . Any tooth from thePreviously Segmented Teeth Model that is found to be within a pre-settolerance away from the starting position is a good surface match andthe tooth is repositioned accordingly.

The surface matching algorithm takes a number of samples of each toothin the Previously Segmented Teeth Model and finds the closestcorresponding sampling point on the jaw image in the Current TeethImage. A grid is created on each tooth and the number of samples israndomly selected and then the grid is overlaid on the Current TeethImage. This is done as the Current Teeth Image needs to match thePreviously Segmented Teeth Model. If the match is off by a millimeter,when repositioned to match the data, the tooth is also off by amillimeter. This process is done iteratively until the deviations arebelow a certain threshold of the overall point data set differences.

Repositioning module 67 allows a technician to utilize a PreviouslySegmented Teeth Model of the patient's teeth to reposition each tooththat has a mismatch or deviation above pre-determined tolerances. Thus,a technician does not need to go through the laborious process ofcreating a segmented tooth model for the Current Teeth Image.Consequently, the Current Teeth image may be a lesser quality image orformat as long as the resolution is high enough to allow the matchingprocess.

When repositioning is completed, the Corrected Stages are communicatedto an output module 68 via an output interface module 70 within analysismodule 58. Output module 68 may be any device with a monitor or anydevice capable of receiving a communication.

It is noteworthy that analysis module 58 may be implemented in softwarecode or by using application specific integrated circuits (ASIC). Thepresent adaptive aspects are not limited to the modular structure shownin FIG. 6 , more or fewer components may be used to implement module 58.

FIG. 7 is a flow chart showing the steps of detecting deviations from aplanned course of treatment to gradually reposition teeth, according toone embodiment of the present disclosure. The process starts in stepS700A, when a Current Teeth Image is received or obtained by atechnician.

In step S700, the Current Teeth Image is pre-processed using a digitaldata software tool and each tooth is assigned a Facial Axis of theClinical Crown (FACC), i.e. a unique current identifier, with jawcharacteristics set. In one embodiment, the Current Teeth Image does notneed to be segmented, which saves a technician's time and hence reducesoverall cost for processing digital teeth data.

In step S701, a Previously Segmented Teeth Model is selected, and isinput into system 56 of FIG. 6 with the Current Teeth Image. Dependingon the stage, the Previously Segmented Teeth Model may be the InitiallySegmented Teeth Model, the Prescribed Tooth Arrangement or some stagethere between.

In step S702, the Previously Segmented Teeth Model and the Current TeethImage are compared. An initial matching algorithm is executed whichmatches the unique starting identifiers (FACCs) of each tooth in thePreviously Segmented Teeth Model to the respective unique currentidentifiers (FACCs) of each tooth in the Current Teeth Image as assignedin step S700. The images are overlaid on each other and the relativelocation of each tooth is identified by its unique identifier (or FACC)to determine if there are any mismatches in step S703. The initialmatching process is performed to determine if there is a gross mismatchso that a technician does not waste time in performing surface matching(step S705) that is described below.

If any mismatches are found, an initial match has not occurred and themismatches are displayed in the form of an informational dialog thatprovides details of the mismatches, such as teeth numberingirregularities or missing FACCs. A mismatch occurs if there are anyteeth numbering irregularities, for example, the total number of teethin each model is not the same, or at least one tooth is missing a FACC.

In step S704, a technician manually adjusts or repositions each toothwith a mismatch using the Previously Segmented Teeth Model or adjuststhe information relating to each tooth with a mismatch. By knowing acurrent location of each tooth, the distance between the currentlocation from a starting location can be measured. Based upon thisdistance, the technician uses the Previously Segmented Teeth Models tomove or reposition each tooth with a mismatch from its present locationto the desired location creating corrected stages. Thereafter, theprocess moves to step S705 that is described below.

If no mismatches are generated in step S703, then an initial matchoccurs and the process moves to step S705. The initial match confirmsthat the technician is using the correct Previously Segmented TeethModel and the Current Teeth Image, which provides a good starting pointfor executing a surface matching algorithm. It is noteworthy thatalthough the process steps S702 (initial matching) and S705 (surfacematching) are shown as separate steps, they may be performed in a singlestep.

In step S705, system 56 (see FIG. 6 ) executes a surface matchingalgorithm. The surface matching algorithm takes a number of samples ofeach tooth in the Previously Segmented Teeth Model and finds the closestcorresponding sampling point on the Current Teeth Image. A grid iscreated on each tooth and the number of samples is randomly selected andthen the grid is overlaid on the Current Teeth Image.

In step S706, any resulting errors from the surface matching algorithmare compared to predetermined tolerances (as described below withreference to FIG. 10 ) to determine if the resulting errors are lessthan the predetermined tolerance. If the resulting errors are less thanthe pre-determined tolerance, then in step S707, the teeth in thePreviously Segmented Teeth Model are repositioned corresponding to acorrected stage.

If the resulting errors are greater than the pre-determined tolerance,then in step S708, error statistics for the surface matching algorithmis output to a display device. The display provides suggestions toperform certain steps to get a better match. In some cases, a technicianmay manually adjust the teeth that did not match in step S706. After themanual adjustment, the process moves back to step S705 and the surfacematching algorithm is re-run.

It is noteworthy that although it is convenient to perform the initialmatching step, a technician may choose to perform only the surfacematching step and based on the results manually adjust the teeth andthen re-run the surface matching step.

It is noteworthy that the adaptive aspects disclosed herein allows oneto track the adjustments made to each tooth of the Previously SegmentedTooth model to match the Current Teeth Image. Furthermore, one cancreate Corrective Stages with the Previously Segmented Teeth model froma tooth arrangement of a Current Teeth Image to a Prescribed ToothArrangement or a Previously Segmented Teeth model.

FIG. 8 is a screen shot showing a graphical representation of athree-dimensional model of a patient's upper and lower jaws 70, 72generated from a Current Teeth Image. As described above, using adigital detailing tool (DDT), a technician pre-processes the CurrentTeeth Image by assigning and placing FACC's or unique currentidentifiers 74 on each tooth in the model. Unique current identifiersare landmarks on the teeth for the purposes of matching which includeattachments or specific characteristics of a tooth. Each FACC has anumber associated with it and that is the tooth number, so the sametooth from the Previously Segmented Teeth Models and the Current TeethImage should be in a similar location.

FIG. 9 is a graphical representation of a three-dimensional model of aninitial match (step S703, FIG. 7 ) that may occur when a PreviouslySegmented Teeth Model is overlaid on the Current Teeth Image, accordingto one embodiment of the present disclosure. The initial match providesa starting position for subsequent surface matching so that a good matchis achieved.

If the initial matching algorithm determines that one or more teeth aremismatched, the initial matching algorithm cannot complete the initialmatching satisfactorily because of teeth numbering irregularities ormissing FACCs. In this instance, the initial matching algorithm willgenerate an informational dialog giving details of the mismatchesallowing the technician to correct them and execute the initial matchingalgorithm again. Also shown in FIG. 9 are four attachments 73, 75, 77,79 that have been added to four of the patient's teeth. An attachmentassists to anchor an appliance to a tooth, assist in moving a tooth to adesired position or correct imperfections in a tooth, such as unevensurfaces, so that the appliances will fit properly.

FIG. 10 is a screen shot of a menu for entering bite match settings,according to one embodiment of the present disclosure for performing thesurface matching process step S705 (FIG. 7 ). Upon selecting the surfacematching algorithm, a menu for entering bite match settings is displayedprompting the technician to enter the bite matching settings. The bitematching settings are pre-determined parameters or tolerances. Thepre-determined tolerances include (1) a matching tolerance which defineswhen the tooth and the Current Teeth Image surfaces qualify as a match;(2) a maximum iteration which is the number of matching iteration stepsthat the algorithm is allowed to run; (3) a fluctuation count whichdefines the number of steps allowed before the algorithm is stopped asan error is not reduced (sometimes the matching algorithm runs into alocal surface matching minimum and can not minimize further to achievethe tolerance as the starting positioning is not good enough, or thereis a discrepancy between the Previously Segmented Teeth Model and theCurrent Teeth Image); and (4) reboot stage information is taken from theRX (or original planned course of treatment as determined by anorthodontist) and used for two types of course correction, reboot andrefinement.

With reboot, the patient has not completed treatment, but the appliancesno longer fits. Each stage in the reboot represents an appliance in theseries of appliances. The technician enters the stage for both the upperand lower teeth where the teeth have strayed from the planned course oftreatment.

With refinement, the patient has completed the planned course oftreatment, but the teeth were not repositioned as expected. In otherwords, the patient has used all the appliances but the teeth stillrequire repositioning requiring the patient to start from the beginningof the process.

Once the technician has entered the pre-determined tolerances, thetechnician selects a match button 76 causing the surface matchingalgorithm to be executed (step S705, FIG. 7 ). During this process eachtooth in the Previously Segmented Teeth Model is matched with thecorresponding tooth in the Current Teeth Image. If a tooth from thePreviously Segmented Teeth Model is found to be within a pre-settolerance away from the Current Teeth Image, it determined (orconcluded) that a good match is found and the program positions thetooth to this new matching transform to create a corrected set ofstages.

When the matching operation is complete the results are displayed in aninteractive dialog box (or user-interface) (81), as shown in the screenshot of FIG. 11 . Dialog box 81 includes a top segment 81A that displaysteeth which were not matched. A user can select a particular tooth, forexample, tooth number 4 (shown in dotted rectangle 81B). This generatesa report on the selected tooth. The report is shown as segment 81C andlabeled as Advanced Properties.

The report identifies the error type (for example, “Collision statisticsmismatch. Was 0.2969 mm (now 0.0906 mm); the distance a tooth needs tomove to create a good match and a suggestion on how to correct theerror. Suggestions are generated by using a current matching distanceand the type of error status (for example, “collision statisticsmismatch”) for each tooth. For example, segment 81C shows the averagematching distance to be 0.0694 and the software interface tells thetechnician to lower the distance to be within 0.030 mm. The techniciancan reposition the mismatched teeth (step S704) and select the“re-match” option (shown by box 82). This re-runs the surface matchingalgorithm.

Dialog box 81 also includes a “Trim colliding teeth automatically”checkbox 80, which allows the technician to indicate if a corrected bite(for example, stage 0 in one of the corrected stages) includes anystripped teeth as the starting (un-stripped) teeth. If the strippedteeth are matched, they can cause severe hard collisions. Selectingoption 80 automatically trims colliding teeth.

When the matching is complete and matching errors for each tooth arebelow the parameters defined by the technician, each tooth from thePreviously Segmented Teeth Model are translated and rotated to create acorrected stage. The teeth are repositioned in stages, where eachappliance in the series of appliances represents a stage. Uponcompletion of the surface matching program, the corrected stage with anoverlay of the corrected stages is displayed to provide visual feedbackon the accuracy of the matching. After all the teeth have been matched,or when the technician decides the match is good enough, the technicianselects done button 78 causing the Previously Segmented Teeth Models tobe automatically deleted.

When no match is found, the matching program is terminated when eitherthe maximum fluctuation count is reached or the maximum iteration isreached. Upon termination, a dialog box is generated identifying theteeth with a matching error greater than the pre-determined tolerances.

As described above, the surface matching algorithm takes a number ofsamples of the Previously Segmented Teeth Model and finds the closestcorresponding sampling point on the jaw image in the Current TeethImage. A grid is created on each tooth and the number of samples israndomly selected and then the grid is overlaid on Current Teeth Image.This is done as the Current Teeth Image needs to match the PreviouslySegmented Teeth Model. This process is done iteratively until thedeviations are below a certain threshold of the overall point data setdifferences.

The surface matching algorithm takes each grid and randomly selects,points and superimposes them. The number of points selected is thenumber of data points that are to be measured. Once all the points havebeen selected and measured, they are superimposed onto the startingteeth setting and if all the differences on average are below athreshold set by the technician (for example 0.07 mm). then there is aclose match.

Both the Previously Segmented Teeth Model and the Current Teeth Imagehave different frames of reference, so in some cases it is possible tonot get a good match. Different frames of reference can occur as aresult of lost enamel, a chipped tooth or a bad impression (air bubble).

When the surface matching algorithm is executed, the parts or teeth thatdid not get a good match are displayed. When there are mismatches, thetechnician then manually repositions the teeth in the PreviouslySegmented Teeth Model (step 5704, FIG. 7 ) and re-runs the initialmatching algorithm for the teeth with the errors. (The Current TeethImage cannot be moved as it is merely a mesh of data.) After re-runningthe initial matching algorithm, any mismatches (or errors) are displayedand technician evaluates whether or not the errors are acceptable.

FIG. 12 is a graphical representation of a three-dimensional model ofthe patient's upper and lower jaw with a matching error, according toone embodiment of the present disclosure. The teeth with matching errorsare marked 84 for easy identification.

A better starting positioning for the matching algorithm needs to beobtained for the teeth identified in the dialog box 81 (FIG. 11 ). Toobtain a better starting positioning, the technician manually adjustseach tooth marked 84 from the Previously Segmented Teeth Model to thedesired location on the corrected stages. FIG. 13 is a screen shot of anenlarged view of a portion of the jaw in FIG. 12 showing matching error84.

FIG. 14 is an enlarged top view of a portion of the jaw in FIG. 12showing the matching error 84. As described with reference to FIG. 4 , atooth is re-positioned by drawing an arbitrary centerline CL through thetooth to be re-positioned. With reference to centerline (CL), tooth 84may be moved in orthogonal directions represented by axes 44, 46, and48. The centerline may be rotated about axis 48 (root angulation) andaxis 44 (torque). Additionally, the tooth may be rotated about thecenterline allowing all possible free-form motions of tooth 84 to beperformed. A guidance box 85 is placed over the tooth 84 with matchingerror and is used as a tool to guide the repositioning of the tooth.

After completing individual teeth matching, the technician selects donebutton 78 in the dialog box shown in FIG. 11 to finish the bite matchingprocess. The program will then compare the teeth matching result to astoppage limit to make sure that the teeth are matched within toleranceand automatically adjust the gingiva and copy the original final setupinto the current case setting. In the preferred embodiment of thepresent disclosure, the limit for all teeth, except the last molars, areset at default 0.1 mm. last molars limit is set at 0.15 mm.

FIG. 15 is a screen shot of a message warning the technician that atleast one tooth is over the acceptable matching surface limit, accordingto one embodiment of the present disclosure. If any teeth are over theacceptable matching surface limit (0.1 mm), a warning message isgenerated telling the technician to re-match the listed teeth to preventthe creation of unfitted aligners. If the technician attempts to finisha case while there are still teeth over the limit by selecting a ‘NO’button 86, the program will prevent the technician from finishing thecase by automatically closing the file, after asking the technician tore-cut the case.

It is possible in some cases that the dialog box of FIG. 11 may displaya large number of teeth that cannot be matched. For those cases thefollowing steps would be performed until a satisfactory result isobtained:

(1) If the initial matching was checked and was satisfactory, then theparameters of the matching might have been too restrictive for theparticular case and it may be necessary to modify the parameters with agreater tolerance and re-run the matching algorithm again;

(2) An impression discrepancy might contribute to the resulting errors.In this case, the technician might decide that the current errors areacceptable and the teeth would actually be in approximately the correctposition (or the same position if the case was re-cut on the correctedbite);

(3) Have excess material removed from the starting impression. and startagain by executing the rough bite matching algorithm; and

(4) Begin the treatment process again as bite matching is not possible.

In one embodiment, since segmentation is not performed on a CurrentTeeth Image, it reduces time for a mid-course correction.

In another embodiment, the Previously Segmented Teeth Model of apatient's teeth is used to detect deviations from the planned course oftreatment which can occur at any stage during the treatment. Byadjusting any teeth that are off track in the Previously Segmented TeethModel, a corrected set of stages can be created. Additional appliancesare generated from the corrected set of stages. The additionalappliances will reposition the patient's teeth to the preexistingPrescribed Tooth Arrangement or a pre-existing stage so that theremainder of the appliances can be used to obtain the prescribed tootharrangement.

While the present disclosure is described above with respect to what iscurrently considered its preferred embodiments, it is to be understoodthat the disclosure is not limited to that described above. To thecontrary, the disclosure is intended to cover various modifications andequivalent arrangements within the spirit and scope of the appendedclaims.

While preferred embodiments of the present invention have been shown anddescribed herein, it will be obvious to those skilled in the art thatsuch embodiments are provided by way of example only. Numerousvariations, changes, and substitutions will now occur to those skilledin the art without departing from the invention. It should be understoodthat various alternatives to the embodiments of the invention describedherein may be employed in practicing the invention. It is intended thatthe following claims define the scope of the invention and that methodsand structures within the scope of these claims and their equivalents becovered thereby.

What is claimed is:
 1. A computer-implemented method for monitoring movement of a patient's teeth, the computer-implemented method executed by a processing unit coupled to a memory storage device storing code, the computer-implemented method comprising: accessing a three-dimensional (3D) digital model of the patient's teeth based on a scan of the patient's teeth; accessing a two-dimensional (2D) image of the patient's teeth, the 2D image based on a camera picture; iteratively comparing teeth of the 3D digital model to teeth of the 2D image by comparing a distance between corresponding points on one or more teeth of the 3D digital model and of the 2D image, and generating an adjusted 3D model of the patient's teeth in which the one or more teeth of the 3D digital model are moved to reduce said distance; and transmitting the adjusted 3D model to an output module for generating an orthodontic treatment plan for realigning the patient's teeth.
 2. The computer-implemented method of claim 1, wherein iteratively comparing the teeth of the 3D digital model to the teeth of the 2D image further comprises comparing surfaces of one or more teeth in the 3D digital model with one or more teeth in the 2D image.
 3. The computer-implemented method of claim 1, wherein iteratively comparing the teeth of the 3D digital model to the teeth of the 2D image comprises iterating until one or more deviations between the teeth of the 3D digital model and the 2D image are below a threshold.
 4. The computer-implemented method of claim 1, wherein accessing the 3D digital model comprises accessing a previously segmented teeth model.
 5. The computer-implemented method of claim 1, further comprising generating the orthodontic treatment plan for realigning the patient's teeth, wherein the orthodontic treatment plan comprises a reboot plan or a refinement plan.
 6. The computer-implemented method of claim 5, wherein generating the orthodontic treatment plan comprises generating at least one corrected stage based on the adjusted 3D model, wherein the corrected stage is based on the adjusted 3D model.
 7. The computer-implemented method of claim 1, further comprising pre-processing the 2D image to assign a unique identifier to each tooth for comparison with the 3D digital model.
 8. The computer-implemented method of claim 7, wherein the unique identifier comprises a specific characteristic of the respective tooth.
 9. The computer-implemented method of claim 7, wherein the unique identifier comprises a Facial Axis of the Clinical Crown (FACC).
 10. The computer-implemented method of claim 7, wherein iteratively comparing the teeth of the 3D digital model to the teeth of the 2D image further comprises comparing the unique identifiers assigned to the 2D image to unique identifiers of the 3D digital model.
 11. The computer-implemented method of claim 1, wherein the 2D image comprises the camera picture.
 12. The computer-implemented method of claim 1, wherein the 2D image is a current teeth image.
 13. A non-transitory computer readable medium for monitoring movement of a patient's teeth, the non-transitory computer readable medium being configured to: access a three-dimensional (3D) digital model of the patient's teeth based on a scan of the patient's teeth; access a two-dimensional (2D) image of the patient's teeth, the 2D image based on a camera picture; iteratively compare teeth of the 3D digital model to teeth of the 2D image by comparing a distance between corresponding points on one or more teeth of the 3D digital model and of the 2D image, and generate an adjusted 3D model of the patient's teeth in which the one or more teeth of the 3D digital model are moved to reduce said distance; and transmit the adjusted 3D model to an output module for generating an orthodontic treatment plan for realigning the patient's teeth.
 14. The non-transitory computer readable medium of claim 13, wherein the non-transitory computer readable medium is further configured to iteratively compare the teeth of the 3D digital model to the teeth of the 2D image by comparing surfaces of one or more teeth in the 3D digital model with one or more teeth in the 2D image.
 15. The non-transitory computer readable medium of claim 13, wherein the non-transitory computer readable medium is configured to iteratively compare the teeth of the 3D digital model to the teeth of the 2D image by iterating until one or more deviations between teeth of the 3D digital model and the 2D image are below a threshold.
 16. The non-transitory computer readable medium of claim 13, wherein the non-transitory computer readable medium is further configured to access the 3D digital model by accessing a previously segmented teeth model.
 17. The non-transitory computer readable medium of claim 13, wherein the non-transitory computer readable medium is further configured to generate at least one corrected stage based on the adjusted 3D model, wherein the corrected stage is based on the adjusted 3D model.
 18. The non-transitory computer readable medium of claim 13, wherein the non-transitory computer readable medium is further configured to pre-process the 2D image to assign a unique identifier to each tooth for comparison with the 3D digital model.
 19. The non-transitory computer readable medium of claim 18, wherein the non-transitory computer readable medium is further configured to iteratively compare the teeth of the 3D digital model to the teeth of the 2D image by comparing the unique identifier.
 20. A multi-module system for monitoring movement of a patient's teeth, the system comprising: a receive module configured to receive a three-dimensional (3D) digital model of the patient's teeth, the 3D digital model having been generated based on a scan of the patient's teeth by a first computing device, and to receive a two-dimensional (2D) teeth image of the patient's teeth comprising a current teeth image, the 2D image based on a camera picture and having been generated by a second computing device; a compare module and a repositioning module, wherein the compare module is configured to iteratively compare teeth of the 3D digital model to teeth of the 2D image by comparing a distance between corresponding points on one or more teeth of the 3D digital model and of the 2D image, and the repositioning module is configured to generate an adjusted 3D model of the patient's teeth in which the one or more teeth of the 3D digital model are moved to reduce said distance; and an output module configured to transmit the corrected 3D model for generating an orthodontic treatment plan for realigning the patient's teeth.
 21. The multi-module system of claim 20, wherein the compare module is configured to iteratively compare the 3D digital model to the 2D image by comparing surfaces of one or more teeth between the 3D digital model and the 2D image.
 22. The multi-module system of claim 20, wherein the compare module is configured to iteratively compare the teeth of the 3D digital model to the teeth of the 2D image by iterating until one or more deviations between the teeth of the 3D digital model of the patient's teeth and the 2D image are below a threshold.
 23. The multi-module system of claim 20, wherein the output module is configured to generate at least one corrective stage based on the corrected 3D model.
 24. The multi-module system of claim 20, wherein the receive module, the compare module, the repositioning module and the output module are part of a network.
 25. The multi-module system of claim 20, further comprising an analysis module configured to pre-process the 2D image to assign a unique identifier for comparison with the 3D digital model.
 26. The multi-module system of claim 25, wherein the compare module is configured to iteratively compare the teeth of the 3D digital model to the teeth of the 2D image of the patient's teeth by comparing the unique identifiers.
 27. A computer-implemented method for monitoring movement of a patient's teeth, the computer-implemented method executed by a processing unit coupled to a memory storage device storing code, the computer-implemented method comprising: providing, to a computing system, a three-dimensional (3D) digital model of the patient's teeth and a two-dimensional (2D) image of the patient's teeth, wherein the 3D digital image is generated based on a scan of the patient's teeth and the 2D image is generated from a camera picture, and wherein the computing system is configured to: iteratively compare teeth of the 3D digital model to teeth of the 2D image by comparing a distance between corresponding points on one or more teeth in the 3D digital model and in the 2D image, and generate an adjusted 3D model of the patient's teeth in which the one or more teeth in the 3D digital model are moved to reduce said distance, and moving one or more teeth in the 3D digital model to reduce the difference between the 2D image and 3D digital model, to generate an adjusted 3D digital model; and receiving, from the computing system, the adjusted 3D model; generating instructions configured to render a graphical representation of the adjusted 3D model for display on a user interface of a computing device; and generating at least one corrected stage based on the corrected updated 3D model.
 28. The computer-implemented method of claim 27, wherein iteratively comparing the teeth of the 3D digital model to the teeth of the 2D image comprises iterating until one or more deviations between the teeth of the 3D digital model and the 2D image are below a threshold.
 29. The computer-implemented method of claim 27, further comprising generating an orthodontic treatment plan for realigning the patient's teeth, wherein the orthodontic treatment plan comprises a reboot plan or a refinement plan.
 30. The computer-implemented method of claim 27, further comprising pre-processing the 2D image to assign a unique identifier to each tooth for comparison with the 3D digital model, wherein the unique identifier comprises a specific characteristic of the respective tooth. 